Bundling Up Central Line Infections

Abstract

<p>Background: The Joint Commission (TJC) found that 72% of CLABSI occurred five days after insertion of central line (The Joint Commission, 2013). Due to these findings, TJC recommends the implementation of pre and post insertion bundles to prevent CLABSIs. Pre-insertion bundles allowed for constant use of evidence &ndash;based practice, however, there is little known about the effects of post-insertion bundles to prevent CLABSI (The Joint Commission, 2013). The use of a bundle would allow for a checklist of evidence-based materials that nurses may use to prevent any lapse in care of a patient that may lead to the development of CLABSI. Purpose: The purpose of this literature review was to analyze the effectiveness of post-insertion bundles and the materials used in the maintenance bundle recommended by TJC compared to current research findings. Methods: Ten articles were reviewed from the 163 articles retrieved using PubMed, CINAHL Complete, NCBI, and OVID databases. &nbsp;Findings: Compliance with maintenance bundle use decreases rates of infection. Chlorohexidine impregnated dressings showed significant decrease in infection occurrence. A 4% Chlorohexidine solution showed to be most effective cleaning agent. Implications: The Joint Commission Central line maintenance protocol does not include the use of Chlorohexidine impregnated dressings and should consider adding this dressing type to bundle. There is no specification to the percentage of Chlorohexidine solution recommendation by TJC; 4% Chlorohexidine should be made the standard cleansing product of the bundle.</p>